Routine inspection·August 9, 2024

On 08/09/2024 at 1:10 p.m. Licensing Program Analysts (LPAs) Maria (Mita) Partoza, Marcela Yanez and Marcella Tarin arrived and conducted an unannounced required 1 year inspection visit. LPA was greeted by 3 staff and the administrator (ADM) Ann Marie Zarraga. LPAs stated the purpose of the visit to ADM. The facility is a Residential Care Facility (RCFE) licensed to serve 60 years and over and approved for 6 ambulatory only. 6 of 6 residents are were present at the time of inspection and are developmentally disabled. At 1:10 p.m. LPA toured the facility inside and outside with ADM, including but not limited to the kitchen, bathroom, dining room, living room, residents rooms, backyard, garage and walkways. The temperature inside the home was at 78 degrees F. LPAs observed a sign posted on the front entry way that states "No Smoking, Oxygen in Use." LPAs with staff (S1) inspected 4 of 4 resident bedrooms. 1 of 4 bedroom is a staff room and 3 of 4 is shared bedroom. LPAs observed 2 bathrooms one on the hallway, and inside the bedroom # (BT1, BT2) LPA observed 3 of 3 resident bedrooms to be organized, sanitary and free from any debris and has sufficient storage for residents' personal belongings. 1 of 3 resident bedroom has a sign posted "no smoking, oxygen in use." 1 of 6 resident uses oxygen as needed and as ordered. LPAs observed that the facility has smoke and carbon monoxide alarm that are in good working condition. LPAs observed hallways, walkways are free from obstruction. LPAs observed the backyard area to be free from debris and is well maintained. LPAs observed a shed in the backyard that stores walkers, facility equipment used by residents in care. The shed has no lock. page 1 of 2 see LIC 809C LPAs observed auditory alarm on the front door. LPAs observed sharps and knives were locked and inaccessible to residents, toxic were observed to be properly stored in locked cabinets. LPAs observe 2 days of perishable food and 7 days non-perishable food. LPAs observed Fire Extinguisher was last serviced on 08/02/2023. LPAs observed refrigerator temperature at 40 degree F, freezer at 0 degree F. LPAs with S1 inspected the garage and observed laundry machine and dryer are in good working. LPAs observe an exit door from the garage that is free from obstruction. LPAs reviewed resident's records, and observed that records are complete and up to date including Centrally Stored Medication and Destruction Record (CSMDR). Medications are labeled and recorded on the CSMDR. LPAs observed First aid Kit to be complete and easily accessible to staff. LPAs reviewed staff record and observed that records are complete and up to date. Certificates for 1st aid was current, annual continuing education training was not documented. The fire and earthquake drill training was last administered in June 29, 2024 and July 5, 2024 respectively. LPAs discussed with ADM the importance of documenting training administered to staff, food safety, thermostat in the freezer and refrigerator to ensure proper temperature is maintained and maintenance of the facility bathroom and screen door by the dining room. Deficiency is cited during today's visit based on California Code of Regulations (CCR) Title 22. See LIC 809D. An exit interview was conducted with ADM Ann Marie Zarraga. A copy of the report and appeals rights were provided.